Retin-A is presented to be the traditional gold standard in dermatology when it comes to anti-aging, but I've seen an increased amount of reports of facial fat loss/hollownesss/sagging in young users. I find this to be concerning, particularly when many doctors encourage people to begin usage at fairly young ages for the purpose of anti-aging.
After spending a lot of time analyzing research on PubMed and encountering studies such as this, this, this, this, and many more, I feel I confirm that retinoic acid directly impairs the process of adipogenesis by inhibiting adipocyte differentiation in several ways both in vivo and in vitro.
I love performing research but I'll be the first to admit that I do not have a science background, so I ran my theory by one of the scientists who writes on the blog BareFacedTruth. *FYI these doctors have created several skincare products, most based on stem cell cytokines, but also sell products containing retinol. That being said they openly admit a certain level of bias but also freely recommend other skincare brands, and do an absolutely amazing job of explaining skincare science.)
I received this response:
"it is well known that all trans retinoic acid reduces expression of adipogenic transcription factors (e.g. PPAR-gamma) and increases fat oxidation. Short-term administration of isotretinoin can even elevates plasma triglyceride concentrations. Suspicious huh? The effect on subcutaneous fat is not at all clear (mostly “ignored” in the medical literature), but switching to an oxidative metabolism is surely suggestive of disrupted lipogenesis, which would at the least interfere with normal tissue maintenance. So your theory may not be all that unorthodox, although poking the sleeping bear (retinoids being all that many dermatologists believe in for anti-aging) could earn you a reputation as a muckraker. Please share your data or observations....Certain native human growth factors can contribute to restoration of fat stores. Facial adipose fat cells have receptors for e.g. IGF-1, and TGF-B3. The response to topical signaling is is growth (mitogenic) and differentiation. Plastic surgeons are gaining experiencing in using GF and cytokine stimulation, typically through autologous stem cell enrichment, to aid in the engraftment of transplanted fat for facial volume enhancement."
So while formal research hasn't really looked into fat loss resultant from tretinoin specifically, there is pretty solid reasoning in being concerned. As far as ways to combat this go, stem cell cytokine products that upregulate IGF-1 and TGF-B3 would be helpful as mentioned above and I've read that azelaic acid activates PPAR-gamma as well. I’m continuing research on peroxisome proliferator-activated receptors and the importance of CCAAT/enhancer-binding protein in fat production. but this is what I've got so far.
If anyone has any experience or info related to this topic, I'd love to hear about it. Most people in the skincare community, dermatologists included, are not willing to question the efficacy of retinoids but no product is above scientific scrutiny and I firmly believe there are better ways of addressing aging skin.
